Impact of Maternal Obesity on Outcomes in Late Preterm Prelabor Rupture of Membranes [11L]

Abstract

INTRODUCTION: Morbidity associated with preterm prelabor rupture of membranes (PPROM) is primarily related to infectious complications and gestational age at delivery. Obesity is a known risk factor for adverse pregnancy outcomes. There is no data on the impact of obesity on outcomes in pregnancies with PPROM after 34 weeks. METHODS: Secondary analysis of a multicenter retrospective cohort study of singletons with PPROM from January 2011-April 2017. Women with a delivery BMI of ≥30 kg/m2 (obese) were compared to women with a delivery BMI of <30 kg/m2 (non-obese). Pregnancies were also stratified based on hospital delivery policies of expectant management (EM) until 35 weeks versus immediate delivery (ID) ≥34 weeks. The primary outcome was neonatal ventilation. Univariate and general estimating equations models were used with p<0.05 level of significance. RESULTS: 259 mother-infant dyads were included and 122 (47%) women were obese. Pregnancies complicated by obesity had increased need for neonatal ventilation as compared to non-obese pregnancies (15.4% in obese versus 8.2% in non-obese, adjusted p<0.001). Obesity was also associated with increased neonatal supplemental oxygen administration, surfactant administration and neonatal antibiotic use >72 hours. However, when stratified by delivery practice and obesity only neonatal antibiotic use >72 hours was significantly lower in obese pregnancies with ID (5.9%) as compared to obese pregnancies with EM (25.0%, p=0.004). CONCLUSION: Pregnancies complicated by PPROM and obesity have an increased risk for neonatal respiratory and infectious morbidity. These findings suggest that obesity and delivery timing impact perinatal outcomes in pregnancies with late PPROM.